The invention relates to a device for closing an opening in a septum located in the heart between two heart chambers, particularly between the right atrium and the left atrium, having a closing element, a feed catheter for the transvenous introduction of the closing element into the interior of the heart and having a puncture cannula as well as a tool or stylet to displace the closing element out of the distal end of the puncture cannula after its piercing through the edge or the neighboring area of the opening located in the heart septum, with at least two individual elements being provided as closing elements, having pulling means or threads, which can be pulled together, connected, and/or knotted for closing the opening in the position of use.
Such a device is known from U.S. Pat. No. 6,056,760. Using the puncture cannula, the edge region of the opening in the heart septum is pierced with the help of the puncture cannula and then an anchoring element with an anchor pin arranged perpendicular in reference to the pulling means is fixed through the interior longitudinal cavity of the puncture cannula such that the pulling means are knotted to each other and thus the edges of the opening can be pulled together and closed. Here, it must be assumed that the heart tissue of the heart septum is elastic in the area of the opening to such an extent that even a very sharply cut puncture cannula deflects the edge region of the heart septum rather than penetrating it. It is a concern that the edge region of the opening is missed, when the puncture cannula engages, thereby preventing a penetration of the puncture cannula and much less an insertion or piercing of the holding element in the edge region of the opening of the heart septum.
This known device is even less suited for closing an opening in a heart septum formed by two overlapping tissue flaps in the heart.